A federal judge on Wednesday ordered HHS Secretary Kathleen Sebelius to allow 10-year-old Sarah Murnaghan to be moved to the adult lung transplant list, giving her a better chance of receiving a potentially life-saving transplant.

The quick and unusual ruling, made after a hastily scheduled emergency hearing, follows a campaign by the family and some members of Congress to pressure the Obama administration to change a federal policy that puts children under age 12 at the bottom of the list of those who can receive donated adult lungs.

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Murnaghan has cystic fibrosis and her doctors have said she may only live a few weeks without the transplant. She has been on the waiting list for pediatric donors for 18 months, but they are more rare and her condition is worsening. There’s no guarantee that even with the judge’s ruling, a suitable donor will become available in time, but her odds would be better.

The case played out amid growing controversy with Sebelius in the spotlight. Several right-wing blogs and commentators depicted her as a one-woman “death panel.” The child’s mother said Sebelius was choosing to let children die.

The judge’s action may have taken some of the immediate heat off Sebelius and the Obama administration. Yet it opened up a host of other questions about organ donation policy and hot-button health care politics.

U.S. District Judge Michael Baylson wrote in a temporary restraining order that by refusing to set aside the existing rule for children, Sebelius had failed “to protect the very few children nationally who are subject to it.” He added that the evidence showed that the rule “discriminates against children and serves no purpose, is arbitrary, capricious and an abuse of discretion.” Baylson, a George W. Bush appointee, scheduled a hearing for June 14.

It wasn’t immediately clear what the judge’s order would mean for the rules that match patients with donors for lung transplants in the country, or how other patients and families in life or death situations would react. The Organ Procurement and Transplantation Network — which helps set national policy — has scheduled an emergency meeting for next Monday and will consider suspending the lung donor policy while it is reviewed, an HHS lawyer said at the emergency hearing in Philadelphia.

Transplant policy — for lungs and other organs — in the U.S. is made and administered by the OPTN working with the United Network for Organ Sharing under contract with the government. It’s inherently difficult because there aren’t enough organs for everyone who needs them, and people do die waiting.